Heart Rhythm Disorders (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- How does the heart work?
- What is a heart rhythm disorder (arrhythmia)?
- What causes heart rhythm disorders?
- What are the signs and symptoms of heart rhythm disorders?
- What are the different types of heart rhythm disorders?
- Premature atrial contractions (PACs) and premature ventricular contractions (PVCs)
- Sinus tachycardia
- Sinus bradycardia
- Abnormal heart rhythms
- Ventricular fibrillation (V-fib)
- Ventricular tachycardia (V-tach)
- Paroxysmal supraventricular tachycardia (PSVT)
- Wolff-Parkinson-White (WPW) syndrome
- Atrial fibrillation (A-fib)
- Atrial flutter
- Heart blocks
- When to seek medical care
- How are heart rhythm disorders diagnosed?
- What is the treatment for heart rhythm disorders?
- What is the prognosis for heart rhythm disorders?
- Can heart rhythm disorders be prevented?
- Find a local Cardiologist in your town
Premature atrial contractions (PACs) and premature ventricular contractions (PVCs)
Every person experiences the occasional palpitation in which the atrium or the ventricle beats early. These premature atrial contractions (PACs) or premature ventricular contractions (PVCs) are normal variants and most people are unaware of their occurrence. However, some patients report a palpitation in the chest and neck, often described as a "thump" or "thud." PACs and PVCs in otherwise healthy individuals do not pose any health risks.
The heart, its cells, and its electricity may come under many outside influences that may cause it to beat more quickly. Sinus tachycardia (sinus = from the SA node + tachy = rapid + cardia = heart), or a rapid regular heartbeat, is a common rhythm issue. It occurs when the body signals the heart to pump more blood, or when the electrical system is stimulated by chemicals.
The body needs increased cardiac output in times of physiologic stress. Cardiac output is the amount of blood the heart pumps in the course of 1 minute. It can be calculated by the amount of blood that the heart pumps with each beat (stroke volume) multiplied by the heart rate.
Cardiac output = (stroke volume) x (heart rate)
The stroke volume tends to be relatively constant. When the body requires extra oxygen delivery, the heart rate needs to increase to meet that demand. Examples include:
- exercise, in which the muscles have greater oxygen requirements and the heart rate speeds up to pump more blood to meet that need;
- dehydration, in which there is less fluid in the body and the heart rate has to speed up to compensate; or
- in cases of acute bleeding that may occur after trauma.
The electrical system can be stimulated in a variety of ways to make the heart beat faster. In times of stress, the body generates cortisol and adrenaline, causing an increased heart rate in addition to other changes in the body. Think of being frightened and feeling your heart race. Increased thyroid hormone levels in the body can also cause a tachycardia. Ingestion of a variety of drugs can also cause the heart to race, including caffeine, alcohol, and over-the-counter cold medications that include chemicals such as phenylephrine and pseudoephedrine. These compounds are metabolized by the body and act like an adrenaline stimulus to the heart. Illegal drugs such as methamphetamine and cocaine can also cause a sinus tachycardia.
Next: Sinus bradycardia
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